Twitter Updates

February 26, 2010

Is Your Hospital Culturally Competent?

Today, people
of color comprise more than one third of the U.S. population. By the year
2050, various ethnic groups and persons of color in the U.S. will total just
over half (51.1 percent) of the population according to U.S. Census Bureau
projections. Close to 90 percent of our total population growth will have come
from high birth rates of persons of color and historic levels of immigration.

The census
projection emphasizes what many have already realized: providing healthcare
services to people who act, talk, relate, dress and eat different from what we
have often considered the “mainstream” will become far more commonplace.
Continued immigration into the U.S., along with increases in the population of
various cultural groups, means that more patients with different cultural
customs, beliefs and practices will enter into the healthcare delivery system.
This brings with it a unique and complex set of challenges for providers.

Culture Shock

While
healthcare is a universal concept that exists in every cultural group, cultures
vary in the ways they perceive health and illness and how care is given.
Culture is predominant force in shaping an individual’s health and response to
illness. For this reason, hospitals must not only provide excellent patient
care, they must also be proficient in “cultural competency,” the understanding
of different cultures, customs, and values.

Some hospital
leaders understand the importance of being culturally competent and have
responded by hiring more multilingual staff and interpreters, and providing
diversity training to help staff members understand their patients’ different
backgrounds. Some changes are even required by various regulatory and
accrediting organizations including The Joint Commission and the U.S. Department
of Health and Human Services Office of Minority Health, Culturally and
Linguistically Appropriate Services (CLAS) standards. These are important steps.
Yet, they are only the beginning of preparing for the reality of a multicultural
and multilingual patient population and workforce.

Cultural Benefits

In
healthcare, the benefits can be much more significant, since in the industry,
the business case accounts for more than return on investment. It translates to
the “top line” of optimal patient care and the “bottom line” of business growth
and sustainability. Healthcare organizations can potentially see the following
in addressing diversity and cultural competency in their organizations:

Top line

Better patient care

In healthcare, the bottom line is providing excellent care to patients.
Although cost has to be considered, people are No. 1. Many reports have
indicated that ethnic minority providers generally care for more minority
patients than their non-minority counterparts. Also, ethnic minority patients
are more likely to be compliant and comfortable with a provider who can speak
their language and/or understands their culture.

Reducing health disparities

Racial and ethnic minorities have higher rates of poor health outcomes
than whites in the case of most diseases, even when controlling for various
factors such as income, employment status, and insurance coverage. Cultural
bias is one contributor to this, according to numerous studies. A diverse and culturally competent workforce
can help reduce health disparities.

Bottom line

Recruit and retain diverse professional talent

Diverse organizations
and companies are seeing the benefits of having a diverse work force. Diversity
and management talent go hand-in-hand. The most talented people seek to work
for organizations that are committed to providing the best-quality services.
They know that an organization that reflects its customers does just that.

Improve market share

Patients of color are the fastest growing population of healthcare
consumers. Communities that include particular cultural groups tend to
patronize and be most loyal to service providers that represent them, that
understand and respond to them and appreciate their differences. As the
population becomes more diverse, the providers that meet the needs of those
diverse patients will become their providers of choice.

Lower healthcare costs

Disease management has been implemented as part of many patient care
plans to improve care and reduce costs. Diversity and cultural competence
programs can reduce cost through communication with patients regarding their
risks and increasing prevention and self-care. While this is the case for
providers and employers, it is also such for all taxpayers and those paying insurance
premiums. If usage increases for an employer as a result of untreated chronic
conditions, the overall pool of payers pays more.

Avoid legal issues

Failure to understand differences of culture or custom may lead to
lawsuits. While this may or may not be warranted, the opportunities for a
lawsuit increase with even the perception that care is not provided equally.

Compliance with accrediting bodies

The HHS Office of Minority Health has implemented standards for
culturally and linguistically appropriate services. The Joint Commission
continues to explore ways to incorporate cultural and linguistic competence.
While The Joint Commission evaluation is not meant to find fault, incorporating
standards into the recommendations serve as a great opportunity for organizations
to improve their cultural proficiency and, simultaneously, meet their business
obligations.

Expand the future work force pipeline

With the current work force shortage, the need for more people to choose
the health professions (particularly nursing, allied health, and STEM fields)
is overwhelming. Encouraging and promoting diversity sends a message to ethnic
minority students in your community that the health professions are a place
where they can make a difference, particularly by seeing professionals they can
emulate.

Good business sense

I’ve mentioned that understanding different patients’ cultures can have a
positive impact on a hospital’s bottom line. Additionally, successful hospitals
understand the need for a highly skilled and diverse workforce. Since the overall
work force is also consistently diversifying and healthcare costs are
skyrocketing, large employers will increasingly scrutinize their health plans
and providers to ensure they have the caretakers and services that meet the
needs of their employee population. Health plans also will want to make sure
their hospital providers reflect their communities. The process is good for all
involved, particularly the patient.

Summary

Many hospitals
and healthcare providing organizations have already begun their journey toward understanding
and integrating the importance of cultural competency – from both a business
and patient-centered care and satisfaction standpoint. They have employed
diversity coordinators, seek diversity training for executive and patient-care
employees and are hiring more interpreters. Those hospitals that prepare for
cultural diversity now are better equipped to provide excellent care and
service. Employers will choose them as their provider. Insurers will enlist.
And the community will support them. The healthcare providers who don’t respond
to this growing need will be left behind.

Where are you
along the cultural competency continuum in your organization? Let us know at
lookingforanswers@cookross.com.